Årsmøde på Munkebjerg

24. oktober 2014
Sted: Munkebjerg hotel

Does Implant surface topography on macro-,micro- and nanolevel influence bone healing and regeneration?

Does Implant surface topography on macro-, micro- and nanolevel  influence bone healing and regeneration?

Although implant treatment today is a common and very predictable treatment for partially edentulous and edentulous patients still there is possibilities to improve the implants for an even better clinical out-come. The implant macro-, micro- and nano features have been regarded as important implant related factors for enhanced bone response during healing and loading. The macro aspects relates to the implant design. The micro aspects relates to what commonly is described as surface roughness while the nano features either are deliberately coated on the implant surface or spontaneously formed during manufacturing. Results from experimental and clinical research will be discussed.

Oral implant surfaces and other matters that may influence periimplantitis around oral implants

If oral implants are placed between the mental foraminae in the mandible older turned implants display similar success rates as do modern devices. However, if any compromised situations such as patient smoking, placing implants in the maxilla or applying direct loading, then modern implants outperform their predecessors significantly. Changing surface microtopography to a moderately rough one is the only surface alteration with demonstrated clinical improvements, but it is possible that alterations in surface chemistry, physics or nano-roughness may have an impact as well. Previous clinical hypotheses of a great incidence of peri-implantitis around commonly used implant surfaces are incorrect; in fact a summed frequency of implant failure and peri-implantitis of within 5% at 10 years or more of follow up is a much more realistic figure than previously reported data. Having said this, in the light of many millions of oral implants being placed annually, peri-implantitis may still represent an important clinical problem. Osseointegration is but a foreign body reaction and to minimize future problems with peri-implantitis, it is important to realize that this problem of a foreign body nature is quite unreated to a disease of teeth named periodontitis.

Does the choice of dental implants matter in the periodontally compromised smokingpatient?

Tobacco smoking is associated with a wide range of well documented health risks including compromised wound healing. Studies on dental implants indicate a higher rate of early and late implant failures in smokers compared to non-smokers. Additionally, smoking is a risk factor for peri-implant marginal bone loss.

Nevertheless, knowledge on the mechanisms behind the deteriorating effects of smoking on Osseo-integration.

Our study in periodontitis susceptible patients found significantly larger loss of turned implants in smokers compared to never-smokers. Interestingly, no significant difference in implant survival or marginal bone loss was observed at oxidized surface in smokers and never-smokers. This implies that oxidized surface implants are more suitable for periodontitis susceptible smoking patients.

Innovative regenerative therapies approaches. A-RF™ & i-PRF™

The main factor for soft and hard tissue healing is the speed and quality of new vascularization.

There are numerous factors that are able to stimulate angiogenesis as growth factors, proteins and hormones. The PRF technique (Platelet Rich Fibrin) releases growth factors regularly and constantly during one week and provides also extra cellular matrix proteins as Fibrin, Collagen IV, Elastin, Thrombospondin, and Fibronectin. With a good stimulation of vessels growth.

Since the beginning of platelet concentrates until today, the role of white cells was often neglected and origin of several controversies. We defended the concept of white cells since the beginning, without scientific evidence.

Actually, there is a considerable evidence that the white cells and specially monocytes and granulocytes are playing a major role in new angiogenesis and bone growth.

It’s the reason why we decided to change the PRF™ protocol: to improve the white cells amount.

The objective was to induce BMPs production from the white cells. Today we can say that we produce BMPs with the Advanced PRF™. But we collect also endothelial cells and stems cells.

We had another objective: It was to find an alternative to the PRP and PRGF injectable, with the white cells concept and with the avoiding of any manipulation or any additive product. It’s the concept of the new i-PRF. Injectable but produced without anticoagulants nor additive product. This i-PRF clots after injection.

Innovative regenerative therapies approaches. A-RF™ & i-PRF™

The main factor for soft and hard tissue healing is the speed and quality of new vascularization.

There are numerous factors that are able to stimulate angiogenesis as growth factors, proteins and hormones. The PRF technique (Platelet Rich Fibrin) releases growth factors regularly and constantly during one week and provides also extra cellular matrix proteins as Fibrin, Collagen IV, Elastin, Thrombospondin, and Fibronectin. With a good stimulation of vessels growth.

Since the beginning of platelet concentrates until today, the role of white cells was often neglected and origin of several controversies. We defended the concept of white cells since the beginning, without scientific evidence.

Actually, there is a considerable evidence that the white cells and specially monocytes and granulocytes are playing a major role in new angiogenesis and bone growth.

It’s the reason why we decided to change the PRF™ protocol: to improve the white cells amount.

The objective was to induce BMPs production from the white cells. Today we can say that we produce BMPs with the Advanced PRF™. But we collect also endothelial cells and stems cells.

We had another objective: It was to find an alternative to the PRP and PRGF injectable, with the white cells concept and with the avoiding of any manipulation or any additive product. It’s the concept of the new i-PRF. Injectable but produced without anticoagulants nor additive product. This i-PRF clots after injection.

Innovative regenerative therapies approaches. A-RF™ & i-PRF™

The main factor for soft and hard tissue healing is the speed and quality of new vascularization.

There are numerous factors that are able to stimulate angiogenesis as growth factors, proteins and hormones. The PRF technique (Platelet Rich Fibrin) releases growth factors regularly and constantly during one week and provides also extra cellular matrix proteins as Fibrin, Collagen IV, Elastin, Thrombospondin, and Fibronectin. With a good stimulation of vessels growth.

Since the beginning of platelet concentrates until today, the role of white cells was often neglected and origin of several controversies. We defended the concept of white cells since the beginning, without scientific evidence.

Actually, there is a considerable evidence that the white cells and specially monocytes and granulocytes are playing a major role in new angiogenesis and bone growth.

It’s the reason why we decided to change the PRF™ protocol: to improve the white cells amount.

The objective was to induce BMPs production from the white cells. Today we can say that we produce BMPs with the Advanced PRF™. But we collect also endothelial cells and stems cells.

We had another objective: It was to find an alternative to the PRP and PRGF injectable, with the white cells concept and with the avoiding of any manipulation or any additive product. It’s the concept of the new i-PRF. Injectable but produced without anticoagulants nor additive product. This i-PRF clots after injection.

Socket grafting made easy?

Tooth loss and subsequent natural remodeling of the alveolar process presents itself as a major challenge in the age of implant dentistry. Reconstruction of the dento-alveolar ridge is often required   for esthetic implant reconstruction and is a major challenge for the surgeon and a burden for the patient.  Socket grafting creates a unique opportunity to prevent the loss of the alveolar process and allows the subsequent implant-reconstruction to be much less complicated. Current protocols therefore are aimed at pre-planning extractions thus allowing for preservation of tissue. The course will give a short review of current concepts, focusing on practical and easy approaches for socket grafting in everyday practice: Socket grafting, made easy!

Betydningen af BIsphosponat medicinering i relation til kirurgisk implantatbehandling

Osteoneonekroser i kæberne har været kendt i mange år i form af

osteo-radio-nekrose. Siden 2003 har verden oplevet en ny epidemi

af osteonekroser (ONJ) fra anti-resorptiv medicin inklusive bisfosfonater

og denosumab. Patienterne, der rammes af ONJ, har enten

osteoporose eller diverse cancerformer med metastaser i knoglerne.

Herudover har vi for nylig konstateret mere sjældne årsager

til osteonekroser, bl.a. efter kemoterapi og efter Herpes Zoster-infektioner,

der griber over på knoglen.

I foredraget gives en oversigt over den sidste udvikling indenfor

osteonekroser. Endvidere belyses hvilken viden vi har om implantatindsættelse

hos patienter i antiresorptiv behandling, inkl. hvilke

risikofaktorer vi skal tage hensyn til.

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